title: Recurrent immune reconstitution inflammatory syndrome of tuberculous brain infection in people living with HIV/AIDS: a case report.
abstract: HIV infection has changed the scenario of infectious disease. HIV-associated immunodeficiency resulted in a wide spectrum of new opportunistic infections. After introduction of antiretroviral therapy (ART), immune reconstitution inflammatory syndrome (IRIS) became an important challenge in management of 10% to 25% of the patients. Meta-analyses of IRIS from various reports published worldwide by Monika Muller et al described 12% IRIS incidence and 15.7% IRIS tuberculosis. Among IRIS tuberculosis, central nervous system involvement with IRIS tuberculous meningitis forms only 7%. Only 9 cases of tuberculous brain abscess is reported in patients with AIDS so far. The IRIS tuberculous brain abscess is very rare, and so far only 1 case is reported as a paradoxical reaction after ART initiation. Here, we report a case of recurrent IRIS tuberculosis meningitis and brain abscess.
authors.affiliation: Government Hospital of Thoracic Medicine, GST Road, Tambaram, Chennai, Tamil Nadu, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Krishnaraj
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Chokkalingam
authors.forename: O R
authors.initials: OR
authors.lastname: Krishnarajasekhar
authors.forename: Ravichandran
authors.initials: R
authors.lastname: Narayanan
authors.forename: Kumar
authors.initials: K
authors.lastname: Sadagopan
authors.forename: Mahilmaran
authors.initials: M
authors.lastname: Ayyamperumal
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000276:immunology* / Q000382:microbiology* / Q000821:virology; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology* / Q000382:microbiology; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000276:immunology* / Q000382:microbiology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000382:microbiology* / Q000821:virology; D008297:Male; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000276:immunology / Q000821:virology*
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents
keywords: immune reconstitution inflammatory syndrome; opportunistic infections; paradoxical reaction; tuberculous brain abscess